children’s psychiatric drugs in wisconsin medicaid: wisconsin’s own three numbers
wisconsin told cms three things about its children in the 2025 reporting year: 62.5 percent of children aged 1 to 11 newly prescribed an antipsychotic had psychosocial care documented first, 20th of the 50 states that reported it; 32.6 percent of children on two or more antipsychotics got both the glucose and the cholesterol test, 15th of the 49 states that reported it; 48.3 percent of children aged 6 to 12 starting an adhd medicine were seen again inside 30 days, 22nd of the 51 states that reported it.[1]
across the whole age range, wisconsin sits above the national median on psychosocial care before an antipsychotic and below the national median on the two metabolic blood tests. same state, same year, same children.
every row wisconsin sent to cms
| measure | wisconsin | denominator | rank | national median |
|---|---|---|---|---|
| APP-CHpsychosocial care first, 1 to 11 | 62.5 | withheld | 20 of 50 | 59.2 |
| APP-CHpsychosocial care first, 12 to 17 | 65.9 | withheld | 20 of 51 | 63.8 |
| APP-CHpsychosocial care first, 1 to 17 | 65.0 | 2,034 | 19 of 51 | 61.4 |
| APM-CHboth blood tests, 1 to 11 | 32.6 | withheld | 15 of 49 | 29.1 |
| APM-CHboth blood tests, 12 to 17 | 29.5 | withheld | 42 of 51 | 36.3 |
| APM-CHboth blood tests, 1 to 17 | 30.3 | 6,810 | 34 of 51 | 32.9 |
| APM-CHglucose alone, 1 to 17 | 53.9 | 6,810 | 29 of 51 | 54.4 |
| APM-CHcholesterol alone, 1 to 17 | 31.5 | 6,810 | 34 of 51 | 34.8 |
| ADD-CH30-day adhd follow-up, 6 to 12 | 48.3 | 7,253 | 22 of 51 | 47.6 |
| ADD-CHnine-month adhd follow-up, 6 to 12 | 48.1 | 4,808 | 37 of 49 | 55.5 |
rank 1 is the highest rate. how the ranks and the withheld cells work.[1]
talking treatment before the antipsychotic
for the youngest children, aged 1 to 11, wisconsin reported 62.5 percent — 3.3 points above the national median of 59.2, and 20th of the 50 states that reported it. put the other way round, 37.5 percent of the youngest children in wisconsin who were started on an antipsychotic had no psychosocial care documented before it. for adolescents aged 12 to 17 the figure was 65.9 percent. across ages 1 to 17, 65.0 percent on 2,034 children, 19th of the 51 states that reported it. it reported 62.6 the year before on the same method, so this one moved 2.4 points up — the only one of the three where that comparison holds. either side of wisconsin on that row: louisiana at 65.9 and kentucky at 64.0.
the two blood tests
wisconsin reported that 32.6 percent of children aged 1 to 11 on two or more antipsychotic prescriptions had both tests — 15th of the 49 states that reported it, 3.5 points above the national median of 29.1. split into halves across ages 1 to 17, glucose ran 53.9 percent and cholesterol 31.5 percent, both on 6,810 children — 29th of the 51 states that reported it on glucose, 34th of the 51 states that reported it on cholesterol. across ages 1 to 17 the both-tests rate was 30.3 percent. either side of wisconsin on the both-tests row for ages 1 to 17: indiana at 30.9 and south dakota at 30.2.
the 30-day visit after a new adhd prescription
48.3 percent, on 7,253 children aged 6 to 12 who were newly prescribed an adhd medicine in wisconsin — 22nd of the 51 states that reported it, 0.7 points above the national median of 47.6. that leaves 51.7 percent of those children with no recorded prescriber visit in the month after the medicine started. over the nine months that follow, 48.1 percent had at least two more visits on 4,808 children, against a national median of 55.5 — 37th of the 49 states that reported it. either side of wisconsin on the 30-day row: pennsylvania at 48.3 and rhode island at 48.0.
what medicaid paid for in wisconsin in 2024
in 2024 medicaid in wisconsin paid for 153,539 hydroxyzine prescriptions, $2,434,857 worth, and 225,758 benzodiazepine prescriptions, $4,780,380 worth — 68.0 hydroxyzine prescriptions for every 100 benzodiazepine ones. 54 of the 274 hydroxyzine rows and 382 of the 1,110 benzodiazepine rows for wisconsin were suppressed, so both are floors.[2] our own sums of the federal file, which has no ages, so neither is a children’s number, and no rank.
four things to ask, with wisconsin’s own numbers behind them
ask which drug it is, not which class
wisconsin, 2024: 153,539 hydroxyzine prescriptions and 225,758 benzodiazepine prescriptions
hydroxyzine is an antihistamine; a benzodiazepine brings dependence and withdrawal. read the name on the bottle. why they get merged.
if an antipsychotic is being started, ask what came first
wisconsin: 62.5 percent of children aged 1 to 11, 20th of the 50 states that reported it
in 37.5 percent of these cases the answer is “none yet”. ask what was tried first, and ask for it in the notes.
if your child is on an antipsychotic, get the date of the bloodwork
wisconsin: 32.6 percent of children aged 1 to 11 had both tests, 15th of the 49 states that reported it
missed 67.4 percent of the time in wisconsin. ask when the glucose and cholesterol test is booked, and leave with a date.
if an adhd medicine has just been started, book the 30-day visit now
wisconsin: 48.3 percent, 22nd of the 51 states that reported it
this is where a dose gets checked and a wrong fit is caught, and wisconsin misses it 51.7 percent of the time. book it before you leave the room.
how to read any of this
self-reported, on methods that differ by state, and process not outcome.[1] method and suppression rules; the national picture.
questions people ask
In Wisconsin, how many children get therapy before they get an antipsychotic?
In the 2025 reporting year Wisconsin reported 62.5 percent for children aged 1 to 11, against a national median of 59.2 percent — 20th of the 50 states that reported it. For ages 12 to 17 it was 65.9 percent, and across ages 1 to 17 65.0 percent on 2,034 children.
In Wisconsin, do children on antipsychotics get the blood tests?
32.6 percent of children aged 1 to 11 on two or more antipsychotic prescriptions had both tests — 15th of the 49 states that reported it, against a national median of 29.1 percent. Across ages 1 to 17: glucose 53.9 percent, cholesterol 31.5 percent, on 6,810 children.
In Wisconsin, how often does the 30-day ADHD follow-up visit happen?
48.3 percent of the time, on 7,253 children aged 6 to 12 newly prescribed an ADHD medicine — 22nd of the 51 states that reported it, against a national median of 47.6 percent. The nine-month measure, two further visits, was 48.1 percent in Wisconsin against a median of 55.5.
sources
- CMS Medicaid/CHIP Child Core Set, 2025 reporting year, Wisconsin rows, read 2026-09-28. APP-CH psychosocial care first, 1 to 11: 62.5 (denominator not publicly reported); APP-CH psychosocial care first, 12 to 17: 65.9 (denominator not publicly reported); APP-CH psychosocial care first, 1 to 17: 65.0 on a denominator of 2,034; APM-CH both blood tests, 1 to 11: 32.6 (denominator not publicly reported); APM-CH both blood tests, 12 to 17: 29.5 (denominator not publicly reported); APM-CH both blood tests, 1 to 17: 30.3 on a denominator of 6,810; APM-CH glucose alone, 1 to 17: 53.9 on a denominator of 6,810; APM-CH cholesterol alone, 1 to 17: 31.5 on a denominator of 6,810; ADD-CH 30-day adhd follow-up, 6 to 12: 48.3 on a denominator of 7,253; ADD-CH nine-month adhd follow-up, 6 to 12: 48.1 on a denominator of 4,808. Method and ranking scope: /medicaid-children. https://data.medicaid.gov/dataset/14bc26c3-5584-4032-9175-f3a0399cb206
- CMS State Drug Utilization Data 2024, Wisconsin rows, summed by product name, read 2026-09-28: hydroxyzine 153,539 prescriptions, $2,434,857, 54 of 274 rows suppressed; benzodiazepines 225,758 prescriptions, $4,780,380, 382 of 1,110 rows suppressed. Our sum, not a CMS statistic. https://data.medicaid.gov/dataset/61729e5a-7aa8-448c-8903-ba3e0cd0ea3c
all 51 states ranked · what the national numbers say
nothing here is a reason to start, stop or change a child’s medication. it is a set of questions to bring to the person who prescribes it.
adam